Expanded polytetrafluoroethylene arterial prostheses in humans: histopathological study of 298 surgically excised grafts

Robert Guidoin, Nabil Chakfe, Sophie Maurel, Thien How, Michel Batt, Michel Marois, Camille Gosselin

Research output: Contribution to journalArticle

79 Scopus citations

Abstract

The expanded polytetrafluoroethylene vascular prosthesis is considered to be the best synthetic alternative for peripheral arterial reconstruction. Most studies on the healing characteristics of expanded polytetrafluoroethylene prostheses have been carried out on animals, and very few data are available on prostheses implanted in humans long term. We implanted 298 expanded polytetrafluoroethylene grafts as arterial substitutes in humans. The mean duration of implantation was 523 d and the grafts were implanted mainly for infrainguinal or axillofemoral bypass. The cellular and collagen infiltration of the microporous expanded polytetrafluoroethylene structure was generally poor. Infiltration occurred mainly in the external region of the prosthetic wall and increased with the duration of implantation. The external reinforcement was not a major factor in limiting tissue infiltration. The luminal surfaces were covered with a thin, irregular layer of organized fibrin, interspersed with exposed expanded polytetrafluoroethylene areas. Mineral deposits were observed in five cases. Despite poor healing, the clinical performance of expanded polytetrafluoroethylene vascular prostheses is relatively good. Since the chief advantage of this material is good mechanical stability in vivo, any modifications of the graft to improve healing characteristics or thrombogenic properties should not be made at the expense of stability in vivo.

Original languageEnglish (US)
Pages (from-to)678-693
Number of pages16
JournalBiomaterials
Volume14
Issue number9
DOIs
StatePublished - Jan 1 1993

Keywords

  • PTFE graft
  • Vascular prostheses
  • explant
  • healing characteristic

ASJC Scopus subject areas

  • Bioengineering
  • Ceramics and Composites
  • Biophysics
  • Biomaterials
  • Mechanics of Materials

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